Current Issues (Full Version)

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ONstudentPT555 -> Current Issues (October 5, 2006 12:29:00 PM)

Hello,

I am writing a paper on the current issues that private practise owners are facing in Onatrio. Can I get some info on what the important current issues that private practise owners are facing and dealing with in Ontario. Also what the profession needs to advocate for and the kind of changes private practise owners would like to see in the future.

Thanks



savela -> Re: Current Issues (October 6, 2006 8:32:00 AM)

HI ONstudent,

I think a big issue in Ontario is not having the direct insurance billing set up yet. Many pts can not afford to pay out of pocket. For those clinics who do the billing for their pts., they take the chance of not getting paid since the check goes directly to the pt. and not to the clinic.

Also in Ontario many MD's own clinics, and refer to their own clinic. Sometimes the pt. is not informed that their doc is the owner. Referral for profit is a big issue. It is difficult to compete with these clinics. I hope this helps.



ONstudentPT555 -> Re: Current Issues (October 9, 2006 12:07:00 PM)

Savlea,

Those seem like some serious issues affecting private clinic owners. Are any of these thing going to change in the coming future?

Will they have direct insurance billing eventually and will there be some sort of regulation of refferal for profit?



Sebastian Asselbergs -> Re: Current Issues (October 10, 2006 2:15:00 AM)

Savela, it not exactly correct that cheques go to the patients all the time. There are companies like Greenshield who accept electronic billing and pay directly, others like Great West Life who will allow "assignment of benefits" - IOW, pay the cheque to the provider. Manulife is another one. Not all their plans have this feature, but we do it with at least 5.
Then there are the MVA patients who only have their autoinsurance - these plans pay the provider directly as well.
In 12 years in this practice, we have to write off about $550 average a year as unclaimable loss. Not a heck of a lot, esp. compared to retail!! LOL



savela -> Re: Current Issues (October 10, 2006 9:29:00 AM)

On Student,

As far as I know the CPA is working on a pilot project with direct billing, so hopefully it will happen soon!



savela -> Re: Current Issues (October 10, 2006 7:27:00 PM)

Sabastian,

Thank you for the clarification. I worked part time in a clinic (over the past 2 years) and they were always chasing money. In my own practice the pt. pays up front, so I do not have to worry about waiting for payment or not getting paid.

I have a dentist and a pharmacist in my family, and they get paid quickly by swiping a insurance card.

Hopefully, this will happen soon in Canada for PT!



Sebastian Asselbergs -> Re: Current Issues (October 11, 2006 1:26:00 AM)

You're most welcome, Savela. In my practice, there will always be some patients who have a hard time coming up with the $$ up front; I will not refuse them service, and we can usually find a way to arrange a mutually beneficial solution. My secretary is absolute GOLD.

Onstudent, the referral for profit (by MDs) issue is one that can not be addressed by the physio associations and organisations alone. We (PTs) have no regulatory powers over MDs and their practices. What we can not do, is give "rewards" to the referral source, but technically, when a patient comes under our care - through whatever referral format: be it word-of-mouth, lawyer, or clinic-owning MD - we have to provide service under OUR standards of practice and code of ethics.
The issue of referring-to-self-owned clinics by MDs is one that the College of Physicians has been looking at for quite a while now - yet, as far as I know, no clear policy has been developed.



ONstudentPT555 -> Re: Current Issues (October 11, 2006 1:57:00 PM)

hello

Thanks for the info guys! I just finished my paper and I tried to touch on most of the issues i felt were important.

What about PTs coming together and refussing to work for the clinics that are owned by MDs.. that would stop the problem. How prevalent are these clinics anyways?

I was talking to a physio i know who told me that as a profession physios just dont have enough unity and initiative to stand up and fight for things that are important for the profession.



savela -> Re: Current Issues (October 11, 2006 4:54:00 PM)

Hi On stu,

I agree with you about PT's comming together and not working for these clinics.

I work in the finance district in TO. There are many of these clinics with very high profiles.

Many pts. love to be treated by the doctor who works for (or use to work for)a professional sports team. They can say they "were treated by the Leafs staff" or any other team.

What really bothers me, is that some PT's who teach the post grad ortho courses and are on the "list" to be supervisors 9to complete the required part A 90 hours) work for these clinics.

Like you, I feel the only way to stop referral for profit is not to work for the MD's.

On the bright side, with hard work I have built my pts referral base through word of mouth and no longer need referring Doc's.

I think PT's who have a good referral base with MD,s are afraid to unite so they do not burn bridges. In the late 90's, many PT,s tried to unite as I recall ( I was in school then)and nothing happened.

I am not sure what school you are studying at? If you are at Mac maybe you should do a seminar on this subject an unite new grads.

I have written to the OPA and CPA about this, and I have not had a response. I hope you did well with your project! Good luck.



Sebastian Asselbergs -> Re: Current Issues (October 12, 2006 2:07:00 AM)

ONstudent: it is not just our profession where you see lack of unity. It happens all over the medical field. And for recent grads, some of the advantages of working in an MD-owned clinic are very tempting - no overhead to speak of, ready-made referral base, steady case load - and thus importantly, a steady and somewhat regular income (great for those student loans!). As long as the therapeutic planning is totally under the autonomous control of the PT, and NOT affected by anything other than clinical aspects, PT-ethics are complied with.
There is NOT always a problem with the ethics of a MD-owned and self-referring clinic, but the opportunity (and the frequent reality) for conflict of interest and abuse of professional power is there.

I don't like the situation, but I can understand it.

I would like to see legislation only allowing PTs to own PT clinics.....Makes the whole issue simple. Then the clinics are as much under the CPO regulations as the individual PTs.
Will that happen? I don't think so....Companies and non-MD individuals can own medical clinics, so to pull the PT-clinics out of non-PT ownership is a very difficult thing to do legally. And how many clinics would be affected? How many PTs work in them? And how many are "bad"? I think a lot more data on the actual "abuse" of the existing situation is needed, before major overhaul will take place.
Remember, we're talking politics here too.......
Hope all goes well for you!



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